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Neonatal disorders mean disturbance of normal state of body, organs and abnormal functions in newborns. Obstetricians play a major role to minimize the number of neonatal disorders. Prematurity, respiratory dysfunction, birth trauma, congenital malformations, neonatal infection and haemolytic disorders of the newborn are some of the examples of neonatal disorders which are commonly encountered. Preventive obstetrics is most important in reducing these disorders. Regular antenatal check-up, balanced diet, iron and folic acid tablet, avoiding repeated pregnancies are some measures which can prevent prematurity. Any factors which cause maternal hypoxia during pregnancy are responsible for fetal hypoxia. Proper antenatal care and avoidance of narcotic drugs in pregnancy are the pillars to combat respiratory dysfunction.
The human genome is often referred to as a blueprint and contains all of the information and instructions necessary for defining a human being. The term genome refers collectively to the DNA and associated protein molecules contained in an organism or a cell. The human genome consists of 23 pairs of chromosomes threadlike packages of genes and other DNA with each parent contributing one chromosome to each pair. A gene is a specific sequence of DNA and is actually the functional unit of inheritance. Most genes contain the information needed to make a protein, or molecules that carry out all of a cell's vital activities. Therefore, slight variations in genes lead to slight changes in a protein.
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or require special medical care due to prematurity, low birth weight, intrauterine growth restriction, congenital malformations (birth defects), sepsis, pulmonary hypoplasia or birth asphyxia. In the United States, a neonatologist is a physician (MD or DO) practicing neonatology. To become a neonatologist, the physician initially receives training as a pediatrician then completes an additional training called a fellowship for 3 years in the US in neonatology. In the United States of America most, but not all neonatologists, are board certified in the specialty of Pediatrics by the American Board of Pediatrics or the American Osteopathic Board of Pediatrics and in the sub-specialty of Neonatal-Perinatal Medicine also by the American Board of Pediatrics or American Osteopathic Board of Pediatrics.
Neonatal hematology is a complex and dynamic process in the pediatric population. Surgeons frequently encounter hematologic issues regarding hemostasis, inflammation, and wound healing. This publication provides a surgeon-directed review of hematopoiesis in the newborn, as well as an overview of the current understanding of their hemostatic profile under normal and pathologic conditions. Neonatal hematology is a complex and dynamic process in the pediatric population. Surgeons frequently encounter hematologic issues regarding hemostasis, inflammation, and wound healing. This publication provides a surgeon-directed review of hematopoiesis in the newborn, as well as an overview of the current understanding of their hemostatic profile under normal and pathologic conditions.
Congenital Malformations are A physical defect present in a baby at birth that can involve many different parts of the body, including the brain, heart, lungs, liver, bones, and intestinal tract. Congenital malformation can be genetic, it can result from exposure of the fetus to a malforming agent such as alcohol, or it can be of unknown origin. Congenital malformations are now the leading cause of infant mortality death in the US and many other developed nations. Examples include heart defects, cleft lip and palate, spina bifida, limb defects, and Down syndrome. Genetic professionals assess the risk of a genetic disorder by researching a family's history and evaluating medical records; weigh the medical, social and ethical decisions surrounding genetic testing; provide support and information to help a person make a decision about testing.
Neonatal lupus is not true lupus. It is a rare condition associated with anti-SSA/Ro and/or anti-SSB/La antibodies from the mother that affect the fetus. At birth, the baby may have a skin rash, liver problems, or low blood cell counts, but these symptoms typically disappear completely after six months with no lasting effects. The most serious symptom is congenital heart block which causes a slow heartbeat. Very rare newborns of women with lupus are at greater risk for developing this potentially life-threatening complication. Congenital heart block is usually detected when the fetus is between 18 and 24 weeks old. The condition does not disappear, and affected infants will eventually need a pacemaker. With proper testing, physicians can now identify most at-risk mothers, and the infant can be treated at or before birth. Most infants of mothers with lupus are entirely healthy.
Newborn babies who need intensive medical attention are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU). The NICU combines advanced technology and trained health care professionals to provide specialized care for the tiniest patients. NICUs may also have intermediate or continuing care areas for babies who are not as sick but do need specialized nursing care. Some hospitals do not have the personnel or a NICU and babies must be transferred to another hospital. Some newborn babies will require care in a NICU. Giving birth to a sick or premature baby can be quite unexpected for any parent.
Central nervous system vascular disorders in the neonate comprise structural anomalies or malformations of arteries and veins and physiologic alterations of cerebral blood flow, which can mimic structural vascular disease. Clinical, imaging, and transcatheter therapeutic aspects of neonatal cerebral vascular malformations are described. Symptomatic high-flow vascular malformations characteristically present with cardiac failure and associated systemic problems in the neonate, whereas infants typically present with macrocephaly and hydrocephalus and older children with hemorrhage, developmental delay, or focal deficits. Neonatal cerebral hemorrhage is typically primary or associated with immaturity, parturitional trauma, or coagulopathy. Likewise, cerebral ischemic lesions are more likely secondary to hypoxic, ischemic events than to thromboembolic or structural cerebrovascular occlusive disease. The role of the current noninvasive imaging modalities in each of these clinical problems is reviewed and illustrated.
General Pediatrics is the branch of medicine that involves the medical care of infants, children, and adolescents. The American Academy of Pediatrics recommends people be under pediatric care up to the age of 21. A medical doctor who specializes in this area is known as a pediatrician. The word pediatrics and its cognates mean healer of children. Pediatricians work both in hospitals particularly those working in its subspecialties such as neonatology, and as primary care physicians. Pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances. The concept of legal consent combined with the non-legal consent or assent of the child when considering treatment options especially in the face of conditions with poor prognosis or complicated and painful procedures/surgeries.
The Neuro Developmental specializes in the integrative treatment of ADHD, autism and related conditions including Tourette syndrome, sensory disorders, behavioral problems, and gastrointestinal problems, asthma and allergies or other developmental issues. It combines the best of both conventional and alternative medicine using what is most effective for each specific child and situation. It evaluates child's overall development including his or her strengths and abilities, as well as challenges. From this process you and your child will then receive a treatment plan that emphasizes natural and safe interventions and that complements your family's unique needs and values. In addition to conducting an initial evaluation and providing recommendations adjusting or changing treatments to ensure your child's wellbeing should also be considered.
Pediatric Gastroenterology is concerned with the study, diagnosis and treatment of a child having a digestive system, liver, or nutritional problem, a pediatric gastroenterologist has the expertise to treat your child. Digestive, liver, and nutritional problems in children often are quite different from those seen in adults. Specialized training and experience in pediatric gastroenterology are important. Pediatric gastroenterologists treat children from the newborn period through the teen years. They choose to make pediatric care the core of their medical practice, which provides extensive experience specifically in the care of infants, children, and teens. Pediatric gastroenterologists generally provide treatment for the following such as bleeding from the gastrointestinal tract, lactose intolerance, food allergies or intolerances, severe or complicated gastroesophageal reflux disease (reflux or GERD), inflammatory bowel disease, short bowel syndrome, liver disease, acute or chronic abdominal pain, and vomiting, chronic constipation, chronic or severe diarrhea, pancreatic insufficiency including cystic fibrosis and pancreatitis, nutritional problems including malnutrition, failure to thrive, and obesity.
Pediatric Nutrition and Diet is concerned with the dietary requirements of the children right from infancy to adolescence. Your child's diet will not only support their normal growth and development, but also supports their immune system, and develops lifelong eating habits. Although dietary needs, appetites, and tastes will vary widely throughout childhood, it is important to consistently provide your child with healthy options from all of the major food groups. Throughout these years, pediatric nutritionist shall closely monitor the dietary requirements of children following increases in length/height, weight, and head circumference on growth curves in relation to increasing age. This close monitoring allows your child's doctor to recognize any growth problems such as failure to thrive, overweight, or other potential growth problems. Early recognition can lead to early intervention, which can provide your child with the tools he or she needs to grow and develop properly.
If a child suffers from allergies or other problems with his immune system, a pediatric allergist/immunologist has special skills to treat that child. If the child has allergies, the immune system wrongly reacts to things that are usually harmless. Pet dander, pollen, dust, mold spores, insect stings, food, and medications are examples of such things. This reaction may cause the child's body to respond with health problems such as asthma, hay fever, hives, eczema or a rash, or a very severe and unusual reaction called anaphylaxis, infections such as sinusitis, inflammation of one or more of the sinuses, pneumonia (infection of the lung), thrush a fungus infection in the mouth, and abscesses collections of pus surrounded by inflamed tissue that keep coming back.
Childhood obesity has become an epidemic in the United States posing a great health challenge to our society. Obese children and adolescents are at high risk of developing type 2 diabetes, cardiovascular disease, high blood pressure, high cholesterol, and other serious health problems. These children are also more likely to develop morbid obesity in adulthood. If a child is overweight or obese, the first step is to ask a pediatrician for weight assessment. Child obesity requires attention from nutritionists, exercise physiologists, and psychologists with expertise in diagnosing and treating childhood obesity. These experts shall evaluate child with obesity and develop a plan to manage your child's weight through nutrition education and behavior modification. Every effort is made to achieve weight loss non-surgically but for a small group of children, medical, behavioral, and nutritional approaches to weight loss may not be enough
Pediatric endocrinology is a medical subspecialty dealing with disorders of the endocrine glands, such as variations of physical growth and sexual development in childhood, diabetes and many more. Pediatric endocrinologists are usually the primary physicians involved in the medical care of infants and children with intersex disorders. The specialty also deals with hypoglycemia and other forms of hyperglycemia in childhood, variations of puberty, as well other adrenal, thyroid, and pituitary problems. Many pediatric endocrinologists have interests and expertise in bone metabolism, lipid metabolism, adolescent gynecology, or inborn errors of metabolism. The most common disease of the specialty is type 1diabetes, which usually accounts for at least 50% of a typical clinical practice. The next most common problem is growth disorders especially those amenable to growth hormone treatment. In the United States and Canada, pediatric endocrinology is a subspecialty of the American Board of Pediatrics or the American Osteopathic Board of Pediatrics, with board certification following fellowship training.
Pediatric Nephrology covers all aspects of acute and chronic diseases that affect renal function in children, as well as on hypertension and fluid and electrolyte metabolism. Pediatric Nephrology deals with the studies on original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. Pediatric nephrologists diagnose, treat, and manage many disorders affecting the kidney and urinary tract, including kidney failure, high blood pressure, inherited kidney diseases, kidney stones, urinary tract infections, and abnormalities in the urine such as blood and protein. They also evaluate and treat problems with growth and development that are specifically related to chronic kidney disease. They are also skilled in helping patients transition from pediatric nephrologists to nephrologists and urologists that care for adult patients.
Adolescent Medicine or hebiatrics is a medical subspecialty that focuses on care of patients who are in the adolescent period of development, generally ranging from the last years of elementary school until graduation from high school. Some doctors in this subspecialty treat young adults attending college at area clinics, in the subfield of college health. In developed nations the period of adolescence is extended both by an earlier start, as onset of puberty is beginning earlier, and a later end, requiring more years of education or training before economic independence from parents. Issues with a high prevalence during adolescence are frequently addressed by adolescent medicine include sexually transmitted disease; unintended pregnancy, birth control, sexual activity such as masturbation, sexual intercourse and sexual abuse, substance abuse, menstrual disorders such as amenorrhea, dysmenorrhea and dysfunctional uterine bleeding, and many more.
Developmental-behavioral pediatrics is a sub-specialty of pediatrics. It requires training in developmental and behavioral pediatrics. The doctors possess training and experience to consider in their assessments and treatments, the medical and psychosocial aspects of developmental and behavioral problems in children and adolescents. The experts understand that children's development and behavior happen first and foremost in the context of the family. They seek to understand the family's view of the problem and the effect of the child's problem on the family. Developmental-behavioral pediatricians advocate for their patients with developmental and behavioral problems by working closely with schools, preschools, and other agencies involved with developmental care and education. Developmental-behavioral pediatricians evaluate, counsel, and provide treatment for children, adolescents, and their families with a wide range of developmental and behavioral difficulties.
Indications for covering children with antibiotics for prophylaxis against infective endocarditis as with adult patients remain unchanged. If a child patient has undergone previous repair of a congenital cardiac defect it is prudent for the dentist to consult with the patient's cardiologist regarding insight as to the presence of residual shunts or defects that may require antibiotic coverage. While many dental offices are now latex free or latex safe, one must consider the multiple possible portals of latex exposure that could exist in the office setting, including emergency airways, nitrous oxide masks, oxygen masks, gloves, bandages, mouth prop covers, rubber dam, and alginate mixing bowls. Patients with a history of certain food allergies, including strawberry, kiwi, bananas, chestnuts, avocado and tomato should be questioned specifically about past reactions to latex, as approximately 50% of patients with latex allergy have a history of another type of allergy.
The preoperative and postoperative care of the pediatric surgical patient is considered under the headings of elective surgery, urgent surgery, surgery for trauma, and other emergency surgery. The specialized care of the neonatal surgical patient is not discussed. The approach outlined is the personal approach of the authors. Points stressed are the importance of preserving normal hydration and blood glucose levels before elective surgery, and the importance of correcting major deficits before urgent or emergency surgery. Pediatric preoperative care and anesthesiology include comprehensive care of the pediatric surgical patient is multifaceted and requires a thorough understanding of the surgical diseases encountered, a detailed knowledge of the physiology of the pediatric population, and an awareness of the unique issues inherent in providing medical care for children. Establishing a healthy and trusting relationship with the child, as well as the child’s parents or guardian, is essential.
Pediatric Genetic Disorders deal with the studies of the division of genetics, birth defects and metabolism provides a full range of services for the diagnosis, counseling and treatment of patients with genetic and congenital disorders. These abnormalities include birth defects, intellectual disability, short stature, genetic syndromes and metabolic disorders. Our physicians have gained an international reputation for their expertise in evaluating and treating neurofibromatosis which causes tumors to form in the nervous system, phenylketonuria (PKU), which if untreated causes intellectual disability, and lysosomal storage disorders which are caused by enzyme deficiencies in the cell, such as the mucopolysaccharidoses, Gaucher disease, Fabry disease, Pompe disease and many others. Care includes multispecialty physician consultations with the patient and family; genetic screening and diagnostic testing; genetic counseling for people who may be at risk of an inherited disease or abnormal pregnancy; full-service, state-of-the-art laboratory testing; and nutritional services for metabolic disorders such as phenylketonuria? (PKU) and other tests and medications.
Pediatric trauma refers to a traumatic injury to infants, children or adolescents. Because of anatomical and physiological differences between children and adults the care and management of this population differs. There are significant anatomical and physiological differences between children and adults. For instance the internal organs are closer in proximity to each other in children than in adults; this places children at higher risk of traumatic injury. Children present a unique challenge in trauma care because they are so different from adults, anatomically, developmentally, physiologically and emotionally. A 2006 study concluded that the risk of death for injured children is lower when care is provided in pediatric trauma centers rather than in non-pediatric trauma centers. An important part of managing trauma in children is weight estimation.